♪ Bob and Brad ♪
♪ the two most famous physical therapists ♪
♪ on the internet. ♪
- Hi folks.
I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- We are the most famous physical therapists
on the internet.
- In our opinion, of course, Bob.
- One minute tennis elbow exercises
that'll help you give you quick pain relief
and maybe even eventually a cure.
- Sure.
- Now everybody's busy out there, Brad.
- Right?
- Nobody's got time to be dealing with this pain.
So we're gonna show you these things you can do
throughout the day.
They only take a minute.
- Right.
- And everybody's got a minute here and there.
- Right. And it's just matter of doing it.
- And, and it really is an issue, Brad,
that a lot of times,
as it will talk,
it's actually gonna be better to do this
spread throughout the day
rather than picking a designated time
because you're trying to remodel tissues.
We'll talk about this.
- Okay. Sure. - So
All right.
Before we do that, Brad,
we got a couple new people out there.
- Two more.
- Two more? - There they are.
- I come too.
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- There you go.
- All right.
The first thing you wanna do is, you know,
you got the tennis elbow,
which means that you got muscles of the forearm
that come and attach on the outside of the elbow.
- Right.
- And they, through overuse or whatever,
maybe through a sport,
you've irritated this area here
and you've, maybe even have some tears in the tendons.
- So right where that connects to the bone.
- Right.
- And usually if you push right in there
in a certain spot,
it'll make you jump pretty good.
- And you've had it, Brad,
- Yep.
- you said it is very painful.
- Oh yeah, yeah.
If you just walk through a doorway
and you bump that bone
right on the on the door jam, it wakes you up.
- Take your mo- - There, there you go.
- So this bone right here.
- Yep.
- And all the muscles attached to that bone
a bunch of forearm muscles.
And they come together there
and that's where the irritation occurs.
- Those muscles are responsible for extending the wrist
- Yeah.
- and as well as some may be into your fingers.
But it's an extension muscle.
- Yeah. Well, if you wanna test to see
whether or not you have it,
bring the wrist up like this
and even bring it a little bit toward you
and then push on it.
And that'll, if that hurts,
- Right.
- that's a good sign that you have tennis elbow.
- Doing an isometric.
- Yep. - Yep.
- So those tissues are damaged
and we have to remodel them, Brad.
- Mhm.
- We want them to get healed strong
so they don't keep breaking open.
We want them to heal strong.
- Kind of like remodeling the house.
You're gonna get everything organized
and get 'em back where it belongs
and make it even better than before, possibly.
- Yes.
- Very good-
- There you go.
- analogy. The first point though
that a lot of people say,
what you want to try is actually probably get an air cast.
Well, not air cast
but any one of the wrist, or sorry, forearm bands.
- Right. So,
- So this is the air cast, pneumatic air band.
- Yep. It's got a little bladder, air bladder
and a lot of 'em have a similar concept
with their air bladder
and some other type of air,
you know where they put pressure on the muscle.
You're not put it right over the bone
but on the muscle belly, just in front of it.
And then you can see,
- Yeah here's the elbow and he's below the elbow.
- Yep. And you tighten it up
and you'll know when you're on the right spot.
Like for me it would be right there.
But it feels better when you're working with it.
- Right.
- That support gives it some relief.
It doesn't cure it, but it takes stresses off it.
And it allows it to heal better.
Usually I'll advise people,
don't wear it tight all day long,
wear it loose if you're not using something.
But if you're gonna do a task
that's gonna create those muscles to work,
tighten it up while you're doing your lifting,
or you're, if you got something
that's especially this motion.
- Right.
- You know.
- Exactly.
- You know, if you're working in the,
if you're a trades person
and you're gonna work with a cordless drills,
matter of fact, cause I've done this once on a weekend.
Wow! Did that flare it up.
- The vibration, too, can be real bad.
- Yeah. If you're doing something with vibration, you bet.
- So you're gonna start with that.
And then what you're gonna do is
start off this remodeling process.
So this is something you can do every,
you know, two hours
or every, or maybe three to four times a day
to start off with.
- Sure.
- And this is gonna seem very basic, and it is very basic
cause you want to make sure that you're strengthening
but you're not re-tearing it open.
You're not making it worse again.
- Right.
- So first you're gonna start with,
you know you find your table, you're working,
just, I want you to start doing this:
Just bringing the hand up like this,
the fingers extended.
- Okay.
- You're gonna do it 10 times.
Now what you're looking for
is that it might hurt when you're doing it.
- Mhm.
- But as soon as you stop, there's no pain.
- Okay.
- If there's pain
I would go ahead and ice and ibuprofen,
all those things to calm the inflammation down.
You're not even ready for this yet.
- Alright.
So you do 10 of them, when you're done,
if it continues to ache after that,
- Right.
- It's too soon.
- That you fired it up, just by doing that.
- Right.
- Then things are really sensitive
- Yep
- and we gotta start off even slower.
If that felt fine, you know,
another couple hours, do another set of 10.
- Okay.
- All right.
First day goes by.
That was easy.
There was not really any, you know, difficulty.
There was no pain.
Now you're gonna go ahead and bring it up and make a fist.
- Okay.
So puts a little more stress - Yep.
- on those muscles, on that tendon.
- Same thing, you know, do it every couple hours.
And if that's not a problem
you might even do it every hour then.
- Okay.
- You know.
- And you're gonna do that on the second day?
- Second day,
- Okay. - third day, whatever
you know, whatever you progress to.
- Okay
- You might be able to do it,
you know, you might be even later
you might have to take longer. - Right.
Right. But if it does feel good after you're done,
- Yep. Same thing.
Does it hurt after you're done?
Does it fire it up by doing that?
Then, you know, - Yep.
- Then you wanna stop.
All right.
Next one, Brad, you're actually gonna do
what we call eccentric strengthening.
So I'm gonna push against the hand
- It's downward.
- and it's gonna stop me
while I'm going down like this
and I'm gonna just do repetitions like this.
So I'm feeling stress on this.
I'm pushing it down.
I'm giving resistance.
- Right.
- And you can do 10 of those.
- So on the way up, you just lift it.
- Yep.
- And then push.
- And if, if that feels fine,
again, nothing after it,
now you're making some headway too.
- Is this something where you might feel something
on the first two or three?
- Well, you should feel it while you're doing it.
- Okay.
- Again, does it hurt afterwards?
- Okay, good.
- No problem to hurt, feel it while,
you know, while it's doing it.
It is expected, even.
Now that one's fine.
Now you can go ahead and go up, also.
- Concentric.
- Yeah, concentric. - We were doing eccentric,
now we're doing concentric strengthening.
- Okay. Now if you're doing these
and you know things are getting better
and it just seems like it's progressing, wonderful.
You're on the right track.
If, if it just seems like it stalls out, Brad.
- Yep.
- Now I'm gonna go ahead and throw it.
And this is one you can actually throw in there
to start off right away, too.
You can do a little cross fiber massage.
- Sure. Yep.
- So you're gonna go ahead.
You're gonna find the bone here
and I'm gonna go just a little bit off the bone
and I'm gonna rub across the fibers
- Right - of the tendon, right?
- Yep.
- Okay.
And you can do this again.
I, I can break, you can break this up.
You can do it for a minute.
- Yep.
- And then, you know,
two hours later do it for another minute.
- Sure. And this is one where
after you do it for about 30 seconds or so,
it should start, it may hurt at first,
but as long as it feels better,
kind of feels numb-ish
after 30 to 45 seconds, then you're okay.
If it just makes it worse and worse, it's too early.
- Right. It, Brad said it eloquently.
- Wow! Thanks, Bob.
- And a lot of times you might wanna take one finger
over the top of the other.
You're pushing down fairly hard.
I mean, you can start off kind of soft, Brad.
- Right.
- But eventually you want to get in there.
Pretty, pretty intense. - You're getting aggressive.
- Yeah.
- Yep, you're gonna get into the muscle
and work that.
You're breaking up that scar tissue.
But remember it's gotta feel better after 30 to 45 seconds.
- Right.
This is one that it,
it needs to start feeling better while you're doing it.
- Sure
- It has to actually numb up.
And if it's not doing that,
then go back to some of the other exercises
or do some of those.
You could start this one actually on day one, Brad,
if, not day one,
but I'd say a couple days later.
- After the initial flare up
it starts to flare up - You could do it
along with these exercises.
- Sure. Yep.
- Now the point I was trying to make, Brad.
If you get stalled out, you're doing this
you're doing this and it's just not getting better.
- Right.
- Then we're, we're starting to think
maybe it's more in the elbow itself.
Not so much on the muscles.
- Okay.
- And, and quite often the sign of that is
if one of the arms does not straighten out
if your, the involved arm does not straighten out
as much as the other, the uninvolved arm.
- So it might look like this.
- Right.
- This one's straight, - Mine, actually,
I don't know if you noticed
but my arm does not straighten out as much.
This one.
- Yeah, you've
- And I do get a little trouble with this.
- you've got problems, Bob.
(Bob laughing)
He's got problems.
- Up here too.
- Yeah.
- And I feel this a lot of times
when I'm doing curls and stuff like this, Brad.
- Okay.
- So see, these are some
of the things I have done and does help.
- Sure.
- So the first one,
this may seem a little crazy, Brad
but you're actually gonna do a self manipulation
where you're gonna try to get it
a little bit straighter again.
- Okay.
- So you, you turn your hand like this.
- Palm in?
- Yeah.
Palm toward you.
And you're gonna jam it into straightening.
Like this.
- All the way out.
- Yeah. And it might hurt a little bit.
- Okay.
- But it should.
- I can hear your elbow. - Yeah, you can hear my
can't you hear my elbow pop. - Oh my God.
- So,
- And this should, pain wise
- It might hurt a little bit,
but again, afterwards, you know
if it starts hurting afterwards, yeah.
- Yeah.
Back off,
- Back off. - don't do it 20 times
- Right, right. - In a row
Just do it a couple, - Two times
- three times.
And it should feel better afterwards.
- The one I like to do, Brad,
is I actually just take my hand
and I, I put it this way
and I turn it a little bit further.
- So you're rotating
- And I bend it this way
and I turn it this way
and I turn it further.
- So that the hand to the shoulder.
- Yeah.
- Flexing that elbow.
- Yep. And I'm turning it each way.
So this time I'm turning it,
that'd be clockwise, right?
- Yeah.
- Clockwise.
- You're gonna rotate it.
- Yeah, I'm rotating it.
I'm turning it.
I'm bending.
- Yeah.
- And then I might also try this way.
Now I'm going counterclockwise.
- Right.
- And I'm going this way.
- Thumb towards your face
or thumb away from your faces.
- I'm sorry.
This is clockwise.
(Brad and Bob laughing)
- We're, we're therapists. - Yeah.
- We're supposed to do internal or external,
- Right.
- pronation or supination,
but we're not gonna get into that.
- Yeah.
- You can see what I'm doing, can't you?
- Yeah.
- That I'm turning it this way.
- Yeah, that way.
Let's go on to the next one, Bob.
- All right.
- People won't care about clockwise.
- Next one is, a good one to do is,
actually just put your hand down like this, flat.
And I'm gonna take the space
between my thumb and my first finger.
I'll go this way, Brad.
- So
- My fingers are facing toward me
and I'm below the elbow,
the elbow's right here
and I'm pushing the elbow,
- That way.
- the whole forearm that way.
And I'm pushing
and I'm trying to straighten the arm at the same time.
- So he's trying to extend or straighten the elbow,
- Yeah.
- and push that direction.
And how hard are you pushing, Bob?
- I'm pushing hard.
- Are you?
- Yeah.
- And what are the red flags to stop?
- Again, I don't want pain on this one.
- Okay.
- Yep.
This one should feel good.
- Right.
- And it, you know
it should feel better after you get done too.
- Right.
- You know?
- Okay.
- And, it's interesting, Brad.
I had a golfer that,
she was actually semi-professional at one point,
and I had her do that one.
And that is the one that took it away.
- That helped her out?
- Yeah.
I mean, and again, we thought it was just all over-use
but it was in the elbow itself.
- Right.
- And so that's like a self-manipulation you can do.
- Right.
And we're getting these, not,
we're not making these up.
These are done,
- Yeah.
These are done by Mulligan and McKenzie.
These are some of the leaders in our field
- Right - that really
- they've been around for 50 years.
- So experiment around with them, you know,
see which ones help.
And hopefully one of 'em does help
and it helps you to get rid of this problem.
- Right. You just gotta keep at it.
You're gonna find the answer.
- And remember Brad, we can fix just about anything.
- Yeah. Except for that...
Oh yeah, that broken
Oh yeah, - Yeah
- Here it is, a broken heart.
Unbelievable. Bob.
- Well, we're gonna work on it.
- Yeah.
We're, we will never give up.
- Thanks for watching.
(Brad chuckles)